Leeds General Practice Confederation

Updated 18 December 2023

Leeds General Practice Confederation (LGPC) is a general practice membership organisation which is made up of 90 practices and incorporates 19 Primary Care Networks (PCNs) in the Leeds area. Services are provided to approximately 870,000 patients.

LGPC was established in 2018 and registered with the Care Quality Commission in December 2018. The provider is currently registered to provide the following regulated activities:

• Diagnostic and screening procedures
• Family planning
• Surgical procedures
• Treatment of disease, disorder or injury

At the time of our inspection, the provider had recently relocated from Stockdale House, and had already submitted documentation to advise us of the new location. We are currently processing this information through our registration system, therefore the changes have not yet been implemented.

The new provider location and administrative centre operates from Building 3 White Rose Park, Millshaw Park Lane, Leeds, LS11 0DL. The organisation is led by a Chief Executive Officer who is supported by the CQC Registered Manager (Head of Operations), the Associate Director (clinical professions), and the Clinical Lead for Compliance and Service Delivery.

LGPC is the enhanced access contract holder for 18 of the Leeds based PCNs for the NHS West Yorkshire Integrated Care Board (ICB) which was formally known as NHS Leeds Clinical Commissioning Group (CCG). The enhanced access service provides face to face and telephone appointments with a range of healthcare professionals. The services are prebookable and provided primarily during evenings and weekends. However, LGPC works individually with each PCN to develop services to suit the needs of the practices and local population.

Patient care for the enhanced access service is delivered from 19 locations (hubs) throughout Leeds:

• City View Medical Practice, 123 Cemetery Road, Holbeck, Leeds, LS11 8LH
• Beechtree Medical Centre, 178 Henconner Lane, Leeds, LS13 4JH
• Rutland Lodge Medical Practice, Scott Hall Road, Chapel Allerton, Leeds, LS7 3DR
• Colton Mill Medical Centre, Stile Hill Way, Colton, Leeds, LS15 9JH
• Gibson Lane Surgery, Gibson Lane, Kippax, LS25 7JN
• Rothwell Health Centre, Stone Brig Lane, Rothwell, LS26 0UE
• Bellbrooke Surgery, Bellbrooke Avenue, Harehills, Leeds, LS9 6AU
• Aireborough Family Practice, Silver Lane Surgery, 1 Suffolk Court, Yeadon, Leeds, LS19 7JN
• The Gables Surgery, Swinnow Green, Pudsey, Leeds, LS28 9AW
• Oakwood Lane Medical Practice, 2 Amberton Terrace, Leeds, LS8 3BZ
• Wetherby Surgery, Hallfield Lane, Wetherby, LS22 6JS
• Ireland Wood Surgery, Iveson Approach, Leeds, LS16 6FR
• Hyde Park Surgery, Woodsley Road, Woodhouse, Leeds, LS6 1SG
• Burley Park Medical Centre, 273 Burley Road, Burley, Leeds, LS4 2EL
• Park Road Medical Centre, 44 Park Road, Guiseley, Leeds, LS20 8AR
• Shaftesbury Medical Centre, 1st Floor, 78 Osmondthorpe Lane, Osmondthorpe, Leeds, LS9 9EF
• Leeds Student Medical Practice, 4 Blenheim Court, Blenheim Walk, Woodhouse, Leeds, LS2 9AE
• Lingwell Croft Surgery, 16 Shelldrake Drive, Middleton, Leeds, LS10 3NB
• Windsor House Surgery, 2 Corporation Street, Morley, Leeds, LS27 9NB

As part of this inspection we visited the provider location at White Rose Park. We also visited 7 hub locations located at Park Road Medical Centre, Aireborough Family Practice, The Gables Surgery, Gibson Lane Surgery, Colton Mill Medical Centre, Rutland Lodge Medical Centre and Bellbrooke Surgery.

Enhanced access appointments are primarily available between 6pm and 8pm Monday to Friday, 8am and 5pm on Saturday and 9am and 3pm on Sunday. However, each service model is tailored to the individual requirements of each of the PCNs, therefore appointments are available outside of these hours. For example, patients have access to musculoskeletal appointments from 6pm until 8pm on Sunday evening at one of the hub locations and another hub location offers appointments with a healthy minds practitioner from 8.30am until 6pm on Wednesday.

Patients can access appointments with the following healthcare professionals via the enhanced access service:

• GP, advanced nurse practitioner and nurse
• Healthcare assistant
• Physiotherapist
• Healthy minds practitioner
• Pharmacist

Patients located in some of the PCNs areas can access specific clinics such as long-acting reversible contraception, childhood immunisations and cervical screening.

Participating practices are allocated a pro-rata allowance for appointments, per 1,000 patients per week and this is monitored by LGPC.

There are parking facilities at all sites and pharmacies are either co-located or in close proximity to the hub locations.

The enhanced access service at all locations is provided by a number of GPs, nursing staff, advanced clinical practitioners, healthcare assistants, physiotherapists, pharmacists and healthy mind practitioners. Some staff work at multiple sites and some at 1 site only. Reception cover is provided by 2 staff at each of the patient facing sites during operational hours, with the exception of 1 PCN which is split across 2 hubs due to the size and area covered.

In addition to the enhanced access service, LGPC also provides the following services:

Same day response which was commissioned in October 2021. This service was designed to support general practices across Leeds and the wider local healthcare economy with acute on the day demand. The service is directly bookable by General Practices, NHS111 (out of hours service), the local clinical assessment service (delivered by Local Care Direct) and pathways are in place to enable Leeds Teaching Hospitals to signpost to the service following clinical triage where clinically appropriate.

Community Ambulatory Paediatric Service. This service was initially established as a pilot in December 2022 to provide an acute Scarlet Fever clinic in response to the Streptococcus A outbreak, with a focus on paediatric access for acute respiratory symptoms. The service was then repurposed to meet the NHS England mandate for acute respiratory infection hubs. Due to the success of the service, this was also commissioned by NHS West Yorkshire ICB in April 2023 to continue through 2023/24.

The same day response service and Community Ambulatory Paediatric Service are provided from 2 locations (hubs):

• Bellbrooke Surgery, Bellbrooke Avenue, Harehills, Leeds, LS9 6AU
• St George’s Centre, St Georges Road, Middleton, Leeds, LS10 4UZ

LGPC provides information to patients via the organisational website:

https://www.leedsgpconfederation.org.uk

How we inspected this service

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Requesting information from the provider prior to the inspection.
• Conducting staff interviews in person.
• Staff questionnaires sent ahead of the head office site visit and returned to us.
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Site visits to the provider location and 7 of the hub sites.
• Requesting feedback from patients via CQC comment cards.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 18 December 2023

This service is rated as Outstanding overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Outstanding

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Outstanding

We carried out an announced comprehensive inspection at Leeds GP Confederation between 2 and 22 September 2023. This was the first inspection of this provider since their registration with the Care Quality Commission in December 2018.

The Head of Operations is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Our key findings were:

• The provider proactively worked with other providers to provide effective care and treatment to the local population by supporting practices within the member primary care networks and the wider health economy.
• The provider had systems and processes in place to maintain oversight of all of the hub locations it operated from, this included premises, health and safety and infection prevention and control.
• The provider had systems in place to keep patients and staff safeguarded from abuse.
• The provider was committed to continuous learning and improvement, we saw evidence of learning through audit activity, and learning from incidents and complaints. Training and support was provided to staff internally and the member primary care networks.
• Feedback from staff regarding the culture of the service was overwhelmingly positive. We heard examples of how staff looked forward to coming to work, felt supported both within their roles and personally and had access to supervision during all hours of the service provided.
• The provider proactively sought feedback from patients regarding services. We saw that patient feedback was generally positive. Where less favourable feedback was received, we saw that the provider had listened to this, and had taken action to improve.
• The provider had a clear vision, all of the staff we spoke with and received feedback from demonstrated their commitment and understanding to the vision and expected behaviours.

We saw the following outstanding practice:

• The provider demonstrated a commitment to supporting the wider health economy to reduce demand on services such as emergency departments and general practice.
• The provider had a good understanding of the needs of the local population. Individualised service level agreements were in place for each of the member primary care networks, giving the flexibility to utilise the enhanced access service to focus on areas of lower performance.

• Staff were proud of the organisation as a place to work and speak highly of the culture. All of the staff we spoke with or received feedback from were proud to work for the service. Many staff members told us they enjoyed coming to work and that it was the best place they had worked.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care